Stacie Sutter, VP, Payer Strategy, Author at Ensemble Health Partners

Delayed or denied payment due to avoidable friction between payers + providers is unsustainable and must be addressed. Here are 3 key causes.

February 10, 2025

Providers are being ignored by contracted and non-contracted MA plans in their efforts to obtain a remedy for 340B drug underpayments.

November 13, 2024

Receiving accurate, timely reimbursement and reducing unnecessary administrative cost imposed by payers requires a proactive strategy.

November 5, 2024

Pre-payment review means you must submit medical records with each affected claim before the payer will agree to pay or adjudicate claims.

September 6, 2024

Reference-Based Pricing plans pay based on a benchmark set by an administrator, rather than based on services rendered or value derived.

May 1, 2024

Since EMR access is so valuable, we encourage providers to take a thoughtful approach before giving it away without an equitable exchange.

August 9, 2023

Medicare Advantage plans have never cost taxpayers less than traditional Medicare, despite that being the entire goal of the program.

August 9, 2023

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